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German authorities now say that  sprouts grown on an organic farm in Lower Saxony are the source of their E. coli O104:H4 outbreak, now responsible for more than 30 deaths and 3,000 illnesses, 750 of them severe kidney disease.

The epidemiological studies point to sprouts after all.

Sprouts, as I mentioned in an earlier post, are a prime suspect in microbial outbreaks.   They have been implicated in many outbreaks in the United States.  This is because sprouts are sprouted from minute seeds that are hard to clean, as shown in this microscopic view:

 

 

 

As Food Safety News explains in a long discussion of this problem, the seeds need to be dumped in bleach to kill bacteria.  It’s also a really good idea to test the wash water to make sure it is free of pathogens.

The seeds are sprouted in water at room temperature, “a warm, moist climate — just perfect for a bacteria’s social life and subsequent reproduction.”

The FDA has been aware of this problem for a long time, as shown by this brief chronology:

• 1999: The FDA issued “nonbinding guidance” on growing sprouts.  This caused the ever-vigilant Center for Science in the Public Interest (CSPI) to file a petition arguing that guidance rules for sprouts needed to be mandatory.
• 2004: The FDA wrote a “note” to producers and shippers of sprouts stating that it was aware of 27 outbreaks of microbial illness due to sprouts and urging producers to follow the voluntary guidance procedures.
• 2004: The FDA followed up by issuing safety guidance for growing sprouts in retail establishments.  These were voluntary, of course.
• 2004: California health officials produced a slide presentation on the hazards of sprout production, urging producers to follow safety guidelines.
• 2005: The FDA announced public meeting to discuss the science of safe production of sprouts as a basis for beginning a rulemaking process for mandatory safety procedures.
• 2009: The FDA issued a warning about consuming alfalfa sprouts.

The Food Safety Modernization act passed last year finally gives FDA the authority to require food safety controls for sprouts.

The German outbreak ought to be a wakeup call for this industry in the United States.  Sellers of bean sprouts market them as health foods but say little about how unsafe they are if eaten raw.

It also ought to be a wakeup call for consumers.  If you aren’t absolutely sure the seeds come from a clean source, cook your sprouts.

I know I said I was done with USDA’s MyPlate, but some of the later commentary is not to be missed.

Steven Colbert, for example, has an interesting take on it (that’s his quote):

 

 

 

 

 

 

 

And so does the pseudonymous “Ruth Bourdain” (no, I have no idea who she or he might be, but I wish I did):

There.  That looks better.

 

 

I’ve had lots of questions from readers about aspects of the devastating E. coli outbreak in Germany and thought it might be useful to round them up and tackle them all at once.

Does anyone understand why this toxic strain of E. coli seems most deadly in women?

It is not clear that these bacteria are more virulent in women than in men.   What seems to be happening is that women are more likely to have eaten salads.  Epidemiologists say that if women are more affected than men in an outbreak, the culprit is likely to be something in salad.  If men are more affected, the source is likely to be meat.

Is it possible it’s from run off from a factory farm, as with the 2006 spinach E. coli outbreak?

That outbreak was traced to a farm in California, but the outbreak E. coli strain was never found on that farm.  It was found at a cattle crossing a mile away.  Did the bacteria get to the spinach through a change in the water table (or runoff), through the droppings of wild boar, or through farm workers?  Nobody really knows but the favorite theory seems to be wild boar (I have my doubts, as I discuss in my book Safe Food: The Politics of Food Safety, 2010).

My question again is can the contaminants be rendered ineffective through high heat cooking, as in stir fry?

Definitely.  Heat kills bacteria, and quickly.  If you are worried about spinach or any other vegetable, drop it in rapidly boiling water for a minute or less.

What is the best way to protect yourself from foodborne illness, especially from fresh produce?

The only way to be 100% sure is to cook food and eat it piping hot.  Short of that: wash your veggies!  Always.  In tap water.  Tap water is chlorinated and will kill most pathogens.  But—and it is a big but—these toxic forms of E. coli are capable of making sticky biofilms that cannot easily be washed off.  Cooking is the only way to be absolutely certain.

What is your feeling about irradiation?

I also discuss irradiation in my book, Safe Food. Lots of people love the idea because it’s an effective kill step.  It is a little rough on lettuce and other leafy greens, however.  Most of all, it’s what I call a late-stage techno-fix.  It fixes the problem after the damage has been done and assumes that no system can be put in place to produce food safely.  But food can be produced safely, and should be.  I love quoting Carol Tucker Foreman on the topic of irradiation: “sterilized poop is still poop.”

Couldn’t it still be sprouts?

It sure could.  As I discussed a couple of days ago, sprouts are always suspicious because they have been responsible for so many other outbreaks.  But they did not turn up as an item in the epidemiologic investigations, when tomatoes, lettuce, and cucumbers did.

Will they ever find the real source?

Only if they are lucky.  It’s now late in the game, although new cases are still reporting in.

Did the Germans botch the investigations?

I can’t tell from here.  Some Americans think they did, and badly, and the Spanish are furious about the destruction of their produce industry.   But I think it’s too soon to judge.  These investigations are difficult at best and the German health care system is, by all reports, highly decentralized.  I want to withhold judgment until more facts are available.

Does Germany have adequate food safety laws?  And, do they enforce them?

I don’t know the specific answer to this.  In general, food safety laws in Europe are more comprehensive than ours.  They have single food safety agencies and farm-to-table rules that we are only just beginning to have.  But the countries are smaller and can do rules like those much easier than we can.   And they have experienced fewer serious outbreaks.  That may be why their reporting systems are not as advanced as ours.

How will the German outbreak affect food safety in America?

It’s hard to say at this point.  Congress seems determined to weaken federal regulatory agencies and cut them off at the knees.  To me, this seems like a dangerous strategy.  I think we need much stronger food safety regulation.  The safety incidents in the last few years provide plenty of evidence that some companies cannot be trusted to produce food safely on their own and that the industry is incapable of policing itself.

That’s where government has to step in.  Congress gave the FDA the authority to require all food producers to produce food following standard safety procedures.  The companies ought to be doing that anyway.

I’m having a hard time figuring out what’s going on with the German outbreak.  How do I find out what’s really going on?

I don’t read German well enough to follow the German press accounts, so I rely on secondary sources.

The Robert Koch Institute, the German equivalent of our CDC, publishes updates translated into English.

Food Safety News has daily updates on many aspects of this outbreak.  It sent a reporter to Germany to cover the events.

Bill Marler also does daily updates on his blog.

Jim Prevor, the Perishable Pundit, has just posted a lengthy discussion of the outbreak from the point of view of the U.S. produce industry.

And for the science, Foodborne Pathogens & Disease.

 

On May 26, the New York Times published a report of a new study on causes of obesity.  The study examined changing rates of physical activity in the workplace. Its conclusion?  Sedentary work is a major cause of rising rates of obesity in the United States.

The shift translates to an average decline of 120 to 140 calories a day in physical activity, closely matching the nation’s steady weight gain over the past five decades, according to the report.

Eric Schlosser and I wrote a letter to the editor pointing out a few flaws in that argument.  The Times did not publish our letter, but here it is:

To the editor:

It makes sense that sedentary work is a factor in the current obesity epidemic (May 26). But it cannot be an important cause. The changing American workplace cannot explain why the obesity rate among the nation’s preschoolers has doubled in recent years and that among elementary schoolchildren has tripled.

The rise in obesity worldwide is linked to the embrace of the American diet, not to a decline in manufacturing.

In China, childhood obesity has increased at least five-fold since 1985.

Simplest explanations are usually best. Reversing obesity means eating less and making healthier food choices.

It also means making it easier to do that by setting policies that promote smaller portions, lower prices on fruits and vegetables, restrictions on marketing food to children, and healthier school meals.

Of course, an increase in well-paid manufacturing jobs would help too.

—Marion Nestle and Eric Schlosser

 

 

 

 

I haven’t said anything about the E. coli 0104 crisis in Germany up to now because I’ve been waiting for the evidence.  Without evidence, the source of the outbreak remains uncertain.

Yesterday, the German minister of agriculture announced that sprouts are the cause.  But are they?

What  is known without question is that the outbreak is deadly serious.  Bill Marler reports these shocking numbers as of June 5:

Deaths = 22 (21 in Germany, 1 in Sweden)

Illnesses = 2,243 (2,153 in Germany, and 90 more in 10 other European nations and the U.S.)

Cases of Hemolytic Uremia Syndrome (HUS) = 627

Why shocking?  This is a devastating disease, excruciatingly painful, with a high probability of causing lifelong complications.  And the disease is almost entirely preventable by following standard food safety procedures.

The idea that the cause is sprouts, and German sprouts at that, comes as a surprise.  Why?  First, sprouts are a frequent cause of foodborne illness and should have been high on the list of suspected foods.  Second, sprouts did not turn up in the case-control studies.

Instead, investigators examined cucumbers, lettuce, and tomatoes (and, in the process, put Spanish cucumber producers out of business).  As Marler explains, the German authorities didn’t want to take a chance, given the results of their investigation.

The case-control investigation was conducted by the Robert Koch Institute, the German equivalent of our CDC.

• The cases: From May 29 to June 2, investigators interviewed 46 affected patients from Bremen, Hamburg and Lübeck about the foods they had eaten.
• The controls: They interviewed 2,100 people who were not sick but were of similar age group, sex and region of residence.
• The results:

Food Reported Eaten         % By Cases     % By Controls

Lettuce                                        84                           47

Cucumbers                                 75                           50

Tomatoes                                   80                            63

95% of the Cases had eaten at least one of the three vegetables.

This evidence strongly implicates these vegetables.  But did they not look for sprouts?

In another related study of people from a Frankfurt business company who had become ill, those who had eaten from the salad bar in the company cafeteria had a 7-fold increased risk of developing bloody diarrhea than those who had not.  No such association was seen for other foods investigated, such as dessert, fruit and asparagus.  Sprouts are not mentioned.  How come?

In trying to figure out what’s going on here, a BBC World News report raises even more questions (my emphasis):

The agriculture minister for Lower Saxony, Gert Lindemann, said there was a clear trail of evidence pointing to a plant nursery south of Hamburg [as the source of the contaminated sprouts].

The nursery has been closed, though officials say the outbreak’s source cannot yet be definitively confirmed.

…Mr Lindemann said epidemiological studies all seemed to point to the plant nursery in Uelzen in the state of Lower Saxony, about 100km (62m) south of Hamburg – though official tests had not yet shown the presence of the bacteria there.

“Further evidence has emerged which points to a plant nursery in Uelzen as the source of the EHEC cases, or at least one of the sources,” he said.  [What evidence?]

…Gert Hahne, a spokesman for the Lower Saxony agriculture ministry, earlier told the Associated Press news agency that many restaurants in which people ate before becoming ill had recently taken delivery of the sprouts. [Guilt by association]

He said authorities would still maintain a warning against eating tomatoes, cucumbers or lettuce.

The health ministry in Berlin said it was still waiting for results from tests on the beansprouts, Germany’s DPA news agency reported.

And the head of the Robert Koch Institute (RKI), Germany’s national disease centre, was also reported as saying that the cause of the outbreak could not yet be confirmed.

So: are sprouts the cause?

By this time, the outbreak is slowing down as the contaminated foods make their way through the food supply.

Could this happen here?  You bet.

If ever there was a time to give the FDA more resources, now is it.  The FDA now has the authority to impose standard food safety procedures on food producers and to require safety measures for the foods we import.   But Congress wants to cut the agency’s budget, and badly.

Now would be a good time to let congressional representatives know that we need a stronger FDA.   And while you are at it, let the USDA know that you think it would be a good idea to regulate other forms of toxic E. coli as adulterants in the same way they regulate E. coli 0157:H7. There is plenty government could do right now to protect us from outbreaks like this one.

A word about sprouts:

How come sprouts are such frequent sources of food safety problems?

Sprouts are grown from tiny seeds that are impossible to wash thoroughly enough to ensure that they are free of harmful bacteria.  The seeds are sprouted in water that must be changed several times a day.  This water is an excellent growth medium for bacteria.  That is why FDA guidance says sprout producers ought to test the wash water for harmful bacteria.

Under the new legislation, the FDA has the authority to enforce this guidance.  But does it have adequate personnel?  Unlikely, given the current stance in Congress.

This just in:  No, it’s not sprouts, according to this bulletin from Food Chemical News:

The latest news, reported this morning by both the Associated Press and BBC, is that 23 of 40 samples of organic sprouts taken from the Gaetnerhof farm in the Lower Saxony region of Germany have tested negative for the bacteria. Tests on the other samples have yet to be returned.

My monthly (first Sunday) San Francisco Chronicle Food Matters column is on guess what?  This will be the last post on the new food icon for a while at least, I promise.

Food plate icon improvement of pyramid

 

 

 

 

 

 

 

 

Q: What’s the big deal over the government’s new food icon? A plate? That seems really boring.

A: The Department of Agriculture’s plate may look banal, but it is a key part of first lady Michelle Obama’s healthy eating campaign and I see it as a big step forward. Unlike the 2005 MyPyramid, this one is mostly about food, is easy to understand, and does not require use of a computer.

The plate does a better job of reflecting current thinking about healthy diets than previous guides. Its four sectors are unequal. Vegetables get the most space, and dairy – a discretionary choice – is off to the side.

You are to pile half your plate with fruit and vegetables, and a quarter with grains (half of them whole grains). All these come from plants.

I’m less happy about the sector marked “protein.” Protein is not a food. It is a nutrient.

USDA must think everyone knows that “protein” means beans, poultry and fish, as well as meat. But grains and dairy, each with its own sector, are also important protein sources. The meat industry wants you to equate protein with meat. It should be happy with this guide.

What I like best are the messages that come with the plate. My favorite? “Enjoy your food, but eat less.”

At last! Enjoyment is part of dietary advice. High marks to USDA for this one.

Other messages are designed to help you eat less while eating better. Smaller portions keep calories under control. Making half your plate fruits and vegetables is a profound switch from the six to 11 calorie-rich grain servings you were supposed to eat daily under the old MyPyramid.

For people who drink milk (really, you don’t have to), switching to low-fat is an effective way to save on calories, and whole grains are better for health than refined, rapidly absorbable starches that behave like sugars in the body.

So far, so good. But next come the politically charged “foods to reduce.” Here, the USDA is leaning in the right direction, but still pulling punches. USDA tells you to reduce sodium from soup, bread and frozen meals, but says nothing about salty snacks or other sodium-laden processed foods. This is a glaring omission.

And the final principle – “drink water instead of sugary drinks” – puts naturally sweet fruit juices (fine in small amounts) in the same category as sugar-added juice drinks, sports drinks and sodas, which ought to be reserved for occasional treats.

Let’s give USDA credit for going as far as it could without directly confronting the processed-food and soft-drink industries.

Optimist that I am, I think the icon has plenty for everyone to work with. It emphasizes the positives – fruits, vegetables, whole grains – and leaves lots of room for enjoyment. You can pile whatever foods you like on that plate as long as they fit within their assigned sectors.

Best of all, you do not have to count numbers of servings. If you want to control the size of your servings, just use a smaller plate.

Consider the alternatives. From 1958 until 1979, the USDA’s uncontroversial Four Food Groups advised eating two or three servings a day from dairy, meat, fruits and vegetables, and breads and cereals – half the plate from animal-source foods.

In 1979, in an effort to help reduce dietary risks for chronic diseases, USDA stacked the groups with plant foods above animal foods, eliciting a furor that led USDA nutritionists to begin a 12-year project to research a new food guide.

USDA released a food guide Pyramid in 1991, withdrew it under protest from meat producers, and re-released it a year later. Meat and dairy producers did not like being at the “eat less” top of the Pyramid. Nutritionists thought it promoted too many servings of high-calorie grains.

In 2005, the USDA replaced that Pyramid with the unobjectionable, food-free MyPyramid. This was impossible to teach (you had to know what each color stood for), eliminated any sense that it is better to eat some foods than others, and required a computer to personalize your own diet.

USDA officials say they spent about $2 million to research and test the new plate logo, create its website, and publicize it. This is a lot or a little depending on your perspective, but a plate is not exactly a new concept. The American Diabetes Association, American Institute for Cancer Research and Canadian government have all used similar plant-focused plates for years. The Physicians Committee for Responsible Medicine has one with a similar design but 100 percent vegetarian.

We can argue over nutritional details, but I think USDA’s plate-plus-messages works better than anything it has done before. The plate works for health and for disease prevention. It took courage to make half of it fruit and vegetables. That’s real progress.

Now the challenge is to Congress: How about fixing agricultural policies so they support these recommendations?

 

 

The playwright Tony Kushner gave his much fought over graduation speech at John Jay College yesterday.  I could not find the complete text online, but here’s what the New York Times says he said (with some editing):

Engage with society’s thorniest issues…find the human in yourself by finding the citizen in yourself, the activist, the hero in yourself.You face a beset and besieged world…Rspond to the planet’s cries for help.

There’s injustice everywhere. There’s artificial scarcity everywhere. There’s desperate human need, poverty and untreated illness and exploitation everywhere.

Everywhere in the world is in need of repair.  So fix it.

Solve these things.

And what does this have to do with food politics?  Everything.  It’s what the food movement is about.

I’ve been collecting public reactions to MyPlate, not least because I’m quoted in many of them.

The USDA collected supportive blurbs from a wide ranging group of supporters (mine among them)

Weight Watchers saluted the new icon in a full-page ad in the Washington Post

The Los Angeles Times covered it (I’m quoted)

The New York Times covered it (I’m quoted)

The Washington Post covered it (I’m quoted)

The Journal of the American Medical Association (JAMA) covered it (I’m quoted)

The New York Daily News covered it (I’m quoted)

The Des Moines Register covered it (I’m quoted)

USA Today covered it and published a photo of the plate with not-quite-fitting food models (I’m quoted)

ObamaFoodorama covered the many restrictions on using the plate (I’m quoted)

FoodNavigator.com covered it, focusing on the protein issue (I’m quoted)

Marian Burros wrote about it for Rodale (I’m not quoted).  She points out:

First of all, the complexities of good nutrition haven’t disappeared. You can find some of them at ChooseMyPlate.gov. And there are factors contributing to obesity—the unhealthy practices of the food industry, the presence of obesogens in the environment, an unsustainable food system to name a few—that won’t go away just because the pyramid is gone.

The American Heart Association supports it.

The American Dietetic Association supports it:

As we have in past years, the American Dietetic Association was deeply involved in the development of the 2010 Dietary Guidelines. And we will use the Guidelines and the new MyPlate to provide the unequalled advice and services of registered dietitians to individuals and communities alike.

Unsurprisingly, the produce industry loves it, according to The Packer and the trade association, United Fresh.

The meat industry spins it (MeatPoultry.com):

We are pleased that the new food icon unveiled today…affirms in a clear and simple fashion that protein is a critical component of a balanced, healthy diet….Lean meat and poultry products are some the most nutrient rich foods available, are excellent sources of complete protein, iron and zinc and maintain an excellent nutrition per calorie ratio.

Amber Healy of Food Chemical News (the site is only open to subscribers) has collected a bunch of food industry responses.  Here are some excerpts:

Jeane Wharton, executive director of the U.S. Dry Bean Council, couldn’t be more delighted with Thursday’s news.  “Beans are a great protein, and they’re also a vegetable,” says Wharton, who observes that her industry’s product benefits twice from the new image.

The American Bakers Association joined in with their praise of the plate, especially for grains “appropriately occupying a large portion on the dinner plate,” which shows that the agencies responsible for nutrition advice “are making a strong statement regarding the importance of grains as the foundation of a healthy lifestyle.

The National Dairy Council, National Milk Producers Federation, International Dairy Foods Association and Milk Processor Education Program (MilkPEP) also praise the new image in a statement released Thursday. While dairy isn’t included on the plate directly, the importance of dairy products in a healthy diet is clear, they say.

“Dairy foods are rightfully being recognized — from the school house to the White House — as an important part of everyone’s diet,” says Jerry Kozak, NMPF’s president and CEO. “USDA’s new icon, with a simple visual metaphor of a serving of dairy products alongside a plate, says it’s vital to consume three servings of low-fat and fat-free dairy foods every day.” [Really?  Vital?  That’s not how I read it.]

Last but not least, Andy Bellatti in his Small Bites blog and Melanie Warner on BNET provide excellent analyses of the disconnect between MyPlate recommendations and current agricultural policies—both coming from the same, historically schizophrenic USDA.

You think “schizophrenic” is too harsh?  The Physicians Committee for Responsible Medicine explains why agricultural policy needs a fix.